As health lobby looks past supercommittee, ‘doc fix’ trumps new Medicare cuts

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Aspirations of a long-term SGR patch should be put to rest, healthcare lobbyists said. But they questioned whether the supercommittee push was ever realistic, because an SGR fix would add to the deficit.

"I never once believed that the Joint Select Committee would be the one to do that," said Julius Hobson, a senior adviser at DC law firm Polsinelli Shughart and a former AMA official.

Hobson said a one- or two-year patch is probably the best doctors can hope for — noting that a one-year delay would require a lame-duck Congress to take up the SGR again after next year's election. Other healthcare lobbyists said they wouldn’t be surprised to see an even shorter measure.

But while the AMA didn’t get the long-term solution it wanted from the supercommittee, the committee’s failure spared the doctors' lobby an even worse outcome.

If the supercommittee had reached a deal on deficit reduction that didn’t include the SGR, it likely would have picked off the easiest offsets for a stand-alone "doc fix" at the end of the year. A fix of any length will probably be offset with cuts to certain providers. Those options are at least still on the table as Congress looks toward a shorter-term SGR fix before the scheduled cuts take effect next year.

But the next "doc fix," however, long it might be, won't be the end of Congress's hunt for healthcare savings.

Health industries were divided over the supercommittee from the beginning. Medicaid is shielded from the automatic cuts under sequestration, so some providers that rely more heavily on Medicaid than Medicare might fare better under the trigger than they would have if the supercommittee had reached a deal, which might have included Medicaid.

Eric Zimmerman, a partner at DC law firm McDermott Will & Emery, said the supercommittee’s failure is no reason for healthcare industries to think they’re off the hook.

"It’s just a matter of time before we’re back in same kind of dialogue," he said.